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Ep. 120: Scott Collins

Scott Collins is the CEO of Link-age and provides insight into the importance of market research and hospitality for senior living residents through strategic group purchasing and market intelligence.  

This show was recorded at the NIC Spring Conference 2020.

Lucas: Welcome to Bridge The Gap podcast with Josh and Lucas. We are in San Diego. It’s a beautiful day, as most days are here in San Diego at the NIC Spring Conference 2020 and Josh, we’ve got an incredible guest on the show. We’d like to welcome Scott Collins. He is with Link-age. Welcome to the show. 


Scott: Thank you so much. I appreciate it all. 


Josh: Welcome. 


Scott: Good to be here. 


Josh: Have you come to a NIC conference before? 


Scott: Yeah, it’s my second year. 


Lucas: Okay, good, good.


Scott: It’s been great. 


Lucas: Well there’s a lot of energy. Our listeners can hear, you know, we are the conference junkies. We make that tour and that circuit every year. And it’s a great way to start off the spring here at NIC where we’re collaborating with not just senior living talk but also healthcare talk, which is going to parlay into some of our discussion today. So, Scott, tell our listeners some of your background to give them some context to our discussion today. 


Scott: Yeah, sure. Thanks. I’ve been with Link-age for almost 18 years. Joined when it was a startup and we had our beginnings as a managed care organization pivoted that in the early 2000s into group purchasing. So we’re actually owned by a group of not-for-profit senior living providers, mostly in Ohio, we have one down in Kentucky that provide independent living, assisted skilled nursing, hospice, home health, Meals on Wheels, you name it. If there’s a way to provide care and support for an older adult, they do it.


And so pretty early on we recognized that through our pivot into group purchasing, we couldn’t cost cut providers into long term sustainability. So we added a few other businesses along the way. One of them being Link-age Ventures so that we could provide a way for our shareholders to see a return on their investment but more importantly, begin to see innovation as it’s coming over the horizon. So, with Link-age ventures, we invest either directly into early stage businesses with products, services and technology, or through our partnership with Ziegler and the Ziegler linkage private equity funds. So, two funds, roughly 63 million, raised 25 companies that we’ve invested in, 90 limited partners in the first fund, a hundred in the second. And we’re in the process of imagining the third one, hopefully looking to form that up and start raising capital towards the latter part of 2020. 

Josh: So much going on. And, you know I had heard about what you do a little bit, I was telling you before the show from our friends at Ziegler who have been gracious to provide some great content to our listeners and appreciate Morrison, our friends at Morrison introducing us to you and helping you get here today. So that’s awesome. 


So tell us a little bit, now that we know a little bit about the context of your background, what’s some of the areas that you guys are focused on specifically right now? Because we talked about three or four very specific avenues and then we’ll maybe touch on a deep dive on one of them.


Scott: Yeah, absolutely. So while group purchasing is our core and investment is what we’re known for nationally, market research is near and dear to our heart. Most research you see currently in the U.S. lumps everybody together in a plus sign after age 65. We recognize that that’s not the right way to look at it. So we have a market research company that helps businesses better understand the older consumer, which we think is really important, not just from a marketing perspective, but more importantly from a product or innovation standpoint. So, we break our research down into five year increments up to North of age 100, done a technology study, one of the first ones of its kind here in the U.S. starting in 2011, to really dig deep into how older adults want to consume and engage with technology. 


But then my pet project that I’ve been looking at over the last two years is something we’re calling Link-age Labs. And it’s this idea of how do we start breaking down silos within the innovation spaces throughout all of healthcare. So what we’ve found is that geographically there’s silos of innovation going on and parts of California, little bit in the Midwest as well as in the Northeast, but a lot of times it doesn’t know what each other is doing. And then also with respect to where people find themselves within the healthcare ecosystem. So acute care folks innovate with acute care folks, senior living with senior living and never the two shall meet. And so, because we’ve seen a lot of that around the country, my thought was can we bring together like-minded organizations with a shared alignment of values and perspectives to say, you know what, we see what the frontline challenges are facing our older adults in this healthcare system. Instead of waiting for some really smart entrepreneur somewhere to sort of figure out a solution to the problem they think we have and then hopefully stumble across the Ziegler Link-age to invest in them. Could we do that same thing ourselves and look at the continuum holistically and instead of innovating for just one part of it, identify ways that we can create solutions that actually play throughout the continuum?


And then the two final pieces of that are looking at how do we incorporate payers at the fuzzy front end of innovation along with folks from the public policy arena. So that if we do create something that’s interesting and that really would play throughout the entire healthcare ecosystem. One, how do we get it paid for? And then two, are there any regulatory hurdles or challenges that we could take down early in the development process? And so that’s really what I’ve been working on for about the last year and a half, actively testing the idea. It seemed to be fairly well received and then we found a couple of health system folks that really liked the concept and want to go deep with us. So that’s what we’re doing right now. 


Josh: So, when you talk about partners like-minded that are coming alongside you, and you mentioned a couple health systems, what does that team composition look like? That’s kind of, or what do you want it to look like? Cause it sounds like you guys are a year and a half in kind of testing the waters, but where do you see that going?


Scott: Yeah, great question. What we really try to do is get that executive sponsorship at the very top level within the organization. So CEO, CFO, COO level. And I’m talking about organizations that are very large compared to us and our members. But more importantly, it’s vital for us to make sure that we’ve got alignment down throughout the organization. So if it’s something that sounds really cool in the C-Suite, that’s a great place for innovation to go and die. But once it gets down into mid-level management and into the front line, is it really making their lives easier? Is it helping them better serve their constituents? Is it something that’s going to not add hurdles to their workflow but create, you know, some take down barriers and make things easier. 


So what we do is we put together cross functional teams. So right now, for instance, we’re working on some technology for back office workflows throughout all of healthcare, not just in the acute space or post-acute space, but throughout it. And so the next step, once we have a concept that we really like, we then put together teams who are going to either be impacted by whatever we’re developing or can really help provide deeper insights and then go in and start testing that conceptually and then identify some betas both within the Link-age member network as well as in the health system space that we can go test these things. So, it’s kind of the crawl, walk, run strategy. Let’s test it, develop it, and it’s all really built on a lean startup concept for us. The idea is can we do these things in a way that’s not going to eat up a bunch of capital and a bunch of time? So, you know, if we’re going to fail, we want to fail fast and we don’t want to fail cheap.  


Lucas: Sure. Can you give some examples of some innovation, innovative products that you have walked through that entire process that have gone to market and actually produced some positive outcomes? Not only just for the users, but clearly the attention is on the demographic of these over 65, but I imagine, I would hope that the end result is to better the lives of older adults through these initiatives, right? Is there any examples that you could walk us through? 


Scott: Yes. So I can give you, I’m going to be a bit cryptic about it because it’s still under NDA. But it’s something that definitely helps address a bit of a workforce challenge as well as a revenue cycle challenge in the post-acute space. So how can we utilize different technologies and different tools to make that process more efficient so that we’re reducing the amount of unpaid claims and helping pay your providers get paid more rapidly, but do it in a way that’s going to make their workforce more efficient. So that’s sort of the tip of the wedge. And then beyond that, looking at other parts of their back office, front office or middle of the house operations where we feel like from a workforce perspective, can we utilize certain technologies in order to optimize that and alleviate some of the burdens or challenges put in place because of the tremendous turnover we’re seeing in this market?


Josh: You’ve touched on one and two of, you know, what everybody’s talking about it NIC and every conference that we get to and its labor challenges revenue cycles and things like that. So obviously those are hot issues, but of this group that you’ve put together, senior living has a lot of challenges. I like to call those opportunities also. How are you narrowing down? Because it seems like, you know, if you’re, if you’ve created this group to tackle challenges, it’s like, wow, there’s so many opportunities for us to look at process improvement. How are things getting on your radar that you pinpoint it and then you say, okay, this is the issue, or these are the issues that we’re going to attack?


Scott: Yeah, great question. What we do is we try to identify themes where we hear a lot of noise and, and really start to uncover the root cause of the pain. Because if we let this go to its final conclusion, we’ll be overwhelmed trying to boil the ocean. And we just can’t do that. So we try to find things that are, that have consistency throughout the entire ecosystem. So, we work with-one of our partners runs a number of very large post-acute networks in the Midwest as well as out West. And so what we try to do is work with them to uncover areas of real challenge that are acute enough that they really need a solution and there’s a customer willing to pay for it but specific enough that we can actually create a solution. And for us it means, you know, filtering out a lot of noise and, and sometimes being really granular and going after things. So, transitions in care is a huge challenge in terms of creating consistency throughout the entire healthcare spectrum. But if we could just take one or two tiny pieces of that and make it more efficient not just for the providers, but for the patients. Those are the types of things that we’re really looking for. 


So, what are those little wedges that we can identify where we have permission to win some of the stuff we look at where it was like, that’s outside of our core competency as well as anybody that we’re bringing to the table. We’re going to bypass that. But then the other piece of this is looking for world-class developers to help us build out these solutions. So we recognize that almost none of the things that we’re going to create are going to come from within. It’s how do we identify those best in class partners out there who may not have any connection to healthcare but they’re just really smart at certain parts of technology. And so we can get them up to speed by being the subject matter expert and then have them basically come in and build solutions for us. That’s what we’re doing with one of the other companies that I’ve talked about earlier.


Josh: I love that. So, chase a rabbit here for just a minute cause you, you mentioned the partnerships and some of this will not, maybe a lot of this won’t come from within. It’s going to be these partners. We firmly believe in that. So could you give us a few insights as to what your team is looking for in a great potential partner? You know, you mentioned a developer partner that might not even be from the space, but what are some of the key things, you know, somebody might be out there listening that might connect with you guys or something. So just kind of bake that up for us. 


Scott: Thank you for asking that. It starts with really the alignment of values, right? Somebody who sees this opportunity in senior living specifically, but healthcare more broadly as a way to really impact the quality and dignity of life. So if they view this just as a big money grab, that’s not consistent with who we are, what we’re trying to solve. So it has to come from, it has to be a place of authenticity in terms of they really want to be in this for the right reasons. 


The next thing we look for is humility. We want to make sure that we as a company are very, very humble in everything that we do. And we look for that in partners because we fully recognize, we know a lot less than we actually know. And what we want to find are people who come into this with kind of a blank slate and not a preconceived set of notions, ideas around what older people can do or what healthcare providers are able to accomplish or, you know, well we can’t do that because the reimbursement environment won’t allow for it. So, we try and have somebody who’s really malleable and able to do things kind of in that gray area of uncertainty. Cause so much of healthcare is not black and white, right? Especially around innovation. 


So we want to find people who will recognize our subject matter expertise. We certainly want to have a huge amount of respect for their subject matter expertise and where those two things can come together. We’ve seen some really cool innovations take place. It’s kind of like recognizing what you’re not good at and recognize what you are good at and finding ways to fill in those gaps. 


Josh: Yeah, I love that. So you’re obviously a visionary. I’ve been at this for a long time. This has kind of been your baby that’s kind of coming out now. So, tell us, where do you potentially see this particular group within your bigger group and some of the challenges over the next five to 10 years? What’s your vision for that?


Scott: Yeah, so it’s, it’s all very connected. So I go back to our core business, which is group purchasing. That is a way for us to continue to build out this distribution network not only for ideas but things that we haven’t invented yet. Because if we can establish trust with our network of customers, then when we do invent something, it’s a much easier way for us to get that adopted by them. So we’re still very hyper focused on growing out our core business, which allows us then to magnify the impact of these other innovations that we’re building up through Link-age Labs. 


With Link-age Ventures, it’s a way for us to, you know, make an immediate impact because those are things that we invest in, things that are kind of ready for prime time right now. So, we can’t take our eye off that ball. We’ve got to make sure that we’re doing a good job of identifying those, you know, innovative solutions and technologies and services and products that are going to make an impact right now, but also with a lens towards the future through Link-age Labs saying, hey, let’s step back. Let’s take a look at not only where healthcare is today, but where it’s going. What is going to be the impact of the boomers on senior living? And everybody salivates over them, they have forever. But you know, a third of the boomers have lots of financial resources, two-thirds of them not so much. So, what’s that impact going to look like for people in the brick and mortar business and how can we partner with folks in brick and mortar to kind of disrupt their own business model or set another way? If the national number say that roughly 10 to 12% of the agent income eligible population are ever going to live inside of some type of senior living community, how can we work with senior living providers to flip it upside down and say let’s go extremely hard after that 90% and not with an eye towards moving them in, but taking our best and brightest and moving it out to them.


Josh: That’s great. So we could talk over a lot of episodes just about this one, you know, Link-age labs and then there’s so many other aspects. Really appreciate you taking time with us. NIC is a very high-pace conference. Appreciate you taking time with us, Lucas will echo this, we will connect our audience to you so they can learn more. Appreciate the time that you’ve given. We always get so much, Lucas and I always talk about after the show we’re like, man we get the front row seat to education. So it’s really awesome. So thanks for joining us.


Scott: Thank you both very much. I really appreciate the opportunity to join you today. I love what you guys are doing and as we talked a little about a little bit earlier, the opportunity you have to impact that next generation of innovators that are going to come into this industry I think is enormous. So thank you guys for doing that.


Lucas: Thank you for the encouragement and we’ll definitely be using that to move forward. And we think Morrison Living for the introduction to you guys there, they’re a great partner. They’re helping fuel the energy behind all of the content that we’re trying to elevate senior living with our leadership platform and the speakers informing, educating and influencing. So very, very grateful. They’re thankful to our listeners that are listening. Connect with us at and all of our social media sites. We’d love to hear from you and we’re hearing so many of you. We really do appreciate that and thanks for listening to another great episode of Bright The Gap.


Thank you to our supporting partners NRC Health, OneDay, TIS, Morrison Living, Argentum, Solinity, and The Bridge Group Construction. 

Ep. 120: Scott Collins